Cozaar (losartan) is used to lower high blood pressure, protect the kidneys from damage in type 2 diabetes, and to protect patients who have an enlarged heart from stroke. With modified dosing it can be used in children as young as 6 years old.

Cozaar is an angiotensin receptor blocker (ARB) that, ultimately, relaxes and widens blood vessels. This action lowers blood pressure, improves oxygen flow, and reduces the heart's overall workload.

Though a potent medication, Cozaar may not be enough to lower particularly high or resistant blood pressure; other antihypertensive treatments are commonly given along with Cozaar, either as separate products or in a combined tablet, such as Hyzaar, which includes a thiazide diuretic as well as Losartan.

Treating Hypertension

Cozaar tablets are taken just once per day, with or without food as desired. Treatment is very similar in treating adults who have hypertension:

• Start with 50 mg once per day.
• After two or three weeks, dosage may be increased to 100 mg per day.
• Do not exceed 100 mg per day. Adding another medication will provide more benefit.

In children age 6 and up dosage is based on weight:

• Administer 0.7 mg per kg of weight, taken once per day.
• Do not exceed 50 mg per day.

Patients who have liver impairment or low blood volume may be started on lower 12.5 or 25 mg doses; these lower doses are also good for children. Very young patients may prefer an oral solution rather than tablets. Otherwise healthy adults may have dosage decreased over time as blood pressure is controlled.

Those trying to manage high blood pressure should attend regular doctor checkups to ensure Cozaar is working correctly and to monitor for developing side effects.

Treatment will likely continue for the remainder of life unless actions are taken to address the underlying issue, which in most cases involves lifestyle changes such as exercise and salt regulation.

Protecting Kidneys

Type 2 diabetes can damage the small blood vessels in the kidneys, which, if untreated, can eventually lead to kidney failure. Those with type 2 diabetes usually have high blood pressure; those very rare patients who have type 2 diabetes but do not have high blood pressure do not need Cozaar, as it will lower blood pressure---hypotension is just as dangerous as hypertension.

Treatment is simple:

• Start with 50 mg once per day.
• After two or three weeks, dosage may be increased to 100 mg per day.

Treatment should continue for as long as it provides benefit, which may be for the remainder of life if lifestyle changes are not made or are not adequate.

Stroke Prevention

Cozaar will lower blood pressure regardless of what it's used for, so in stroke prevention it's given when the patient has both hypertension and left ventricular hypertrophy, an enlarged heart. These patients are at particular risk of stroke.

Treatment in this case also involves a diuretic, usually hydrochlorothiazide. Cozaar is available in combination with hydrochlorothiazide in the product Hyzaar, for those who prefer to take just one tablet, or the two can be taken individually.

Treatment is typically:

• Start with 50 mg losartan once per day.
• After several days, add 12.5 mg of hydrochlorothiazide.
• The end goal is 100 mg losartan and 25 mg hydrochlorothiazide per day, but depending on blood pressure this may not be attainable.

Black patients should note that this medication may be only marginally effective, or not effective at all. Beta-blockers like atenolol (brand name Tenormin) produced much better result for black patients in studies.

Side Effects

Serious side effects from Cozaar are rare, but they do unfortunately happen. Be alert for and seek medical attention if experiencing:

• Painful urination
• Difficulty breathing
• Chest pain
• Rapid, slow, or irregular heartbeat
• Loss of movement
• Severe weakness
• Confusion

Most side effects are much milder, and they typically stop occurring as the body adjusts to treatment:

• Dizziness
• Dry cough
• Stuffy nose
• Sore throat
• Mild back pain

Cozaar can cause harm to unborn babies, especially if taken in the second or third trimester. Pregnant women should avoid this product. Effects on nursing infants are unclear.